NATIONAL DAILY HOSPITAL NEWS
EXECUTIVE BRIEFING
Tuesday November 25th, 2025
Today:
>Margin Gaps: More than 1/3rd of Hospitals in the Red
>Rising Medicare Part C Authorization Delays, Denials, and Impact on LOS, Mortality and Hospital Costs
>AI Decision-Making; New Evidence Backs Smart Discharge Lounges
>SNF capacity, availability and impact on Readmission
>Solution Case Studies: Intelligent Huddles, Virtual Patient Care, Telepsychiatry, Post Stay Communication, White Boards, LOS, Readmissions and Patient Engagement Scores
TOPIC 1 — Margin, Revenue & Reimbursement
News
Financial gap persists: more than one-third of hospitals still losing money
National analysis drawing on Kaufman Hall’s Flash Report data finds that 37% of U.S. hospitals remain in the red, even as margins have improved overall, highlighting continued pressure on smaller and rural facilities. Becker's Hospital Review
https://www.beckershospitalreview.com/finance/37-of-hospitals-still-losing-money/
2025 outlook: hospital finances stabilizing, but cost headwinds remain
A 2025 hospital finance outlook notes rising operating margins and growing outpatient revenue, but warns that labor, drug, and supply costs will continue to squeeze many organizations. Fierce Healthcare
https://www.fiercehealthcare.com/hospitals/2025-outlook-hospital-finance-show-signs-stability-rising-costs-will-be-headwind
Medicare Advantage audits and prior authorization remain a revenue risk
Recent federal and advocacy reports continue to highlight high denial and overturn rates in Medicare Advantage, with OIG and MedPAC analyses underscoring how prior authorization and coding audits affect hospital payment stability. MedPAC+1
https://medicareadvocacy.org/medicare-advantage-updates-audits-payment-and-prior-authorization/
https://www.medpac.gov/wp-content/uploads/2024/06/Jun24_Ch2_MedPAC_Report_To_Congress_SEC.pdf
Recommendations
Tighten denial prevention with AI-enabled revenue integrity and denial analytics
Recent work from revenue cycle and consulting groups shows that applying AI and automation to denial prediction and correction can reduce denial rates, rework, and revenue leakage—especially for high-dollar claims. uasisolutions.com+1
https://www.uasisolutions.com/tackling-the-surge-in-healthcare-denials
https://www.aspirion.com/revolutionizing-revenue-cycle-management-ais-answer-to-the-claims-denials-crisis/
Link CDI, coding, and compliance teams to MA audit findings
New case-based toolkits recommend using OIG and MA audit findings to map your own risk areas, target documentation improvement, and proactively clean up high-risk diagnosis and procedure code usage. Office of Inspector General+1
https://oig.hhs.gov/reports/all/2024/medicare-advantage-compliance-audit-of-specific-diagnosis-codes-that-humana-health-plan-inc-contract-h2649-submitted-to-cms/
https://www.aha.org/system/files/media/file/2025/10/Trailblazers_Ailevate_ClaimsDenials.pdf
Case Study
Case Study: AI-assisted denial recovery improves cash and reduces rework
An AHA-profiled health system implemented an AI-driven denial resolution platform (Ailevate) that automatically identifies and corrects high-impact coding denials, reporting faster reimbursement and reduced manual rework as a result. American Hospital Association
https://www.aha.org/system/files/media/file/2025/10/Trailblazers_Ailevate_ClaimsDenials.pdf
TOPIC 2 — Inpatient Throughput
News
Hospital capacity in 2025: LOS gains undercut by discharge delays
A national review notes that average length of stay has improved modestly, but progress is threatened by discharge delays tied to post-acute capacity, especially in nursing homes and rehab. Becker's Hospital Review
https://www.beckershospitalreview.com/care-coordination/hospital-capacity-in-2025-5-notes-on-volumes-boarding-and-length-of-stay/
Discharge lounges gain traction as a flow and experience strategy
Hospitals report that well-run discharge lounges free up inpatient beds earlier in the day, support ED decompression, and can also improve patient satisfaction when designed around comfort and communication. Riverside Health+1
https://www.riversideonline.com/en/about/newscenter/insights/the-discharge-lounge-model
https://www.myamericannurse.com/implementation-of-a-discharge-lounge/
Recommendations
Adopt early discharge prediction tools to drive “planned discharges”
Evidence from Mayo Clinic’s Early Screen for Discharge Planning (ESDP) and more recent AI discharge-prediction work shows that identifying discharge needs early reduces LOS, readmissions, and discharge delays. PubMed+2SpringerLink+2
https://pubmed.ncbi.nlm.nih.gov/29777381/
https://link.springer.com/article/10.1007/s00520-018-4252-8
https://orthosurgery.ucsf.edu/sites/default/files/2025-09/PDF-D1-1145-2-Guarni-Arthroplasty%20Conference%20Presentation_0.pdf
Standardize discharge lounge and bed-turnover workflows
Case reports from U.K. and U.S. hospitals show that structured discharge-lounge criteria, standard work, and Plan–Do–Study–Act cycles can increase same-day discharge volumes and reduce LOS variation. library.sath.nhs.uk+1
https://www.library.sath.nhs.uk/wp-content/uploads/2024/02/Case-study-discharge-lounge-6-week-PDSA.pdf
https://www.sciencedirect.com/science/article/abs/pii/S0196064419314337
Case Study
Case Study: Discharge lounge model improves flow and LOS in a regional system
Riverside Health describes how a dedicated discharge lounge and nurse-led coordination reduced length of stay and improved afternoon bed availability by moving “ready for discharge” patients out of inpatient rooms earlier in the day. Riverside Health
https://www.riversideonline.com/en/about/newscenter/insights/the-discharge-lounge-model
TOPIC 3 — Emergency Department Throughput
News
ED boarding declared a national public health crisis
Emergency medicine organizations describe emergency department boarding as a “decades-long problem” that has become a national crisis, with strong associations to higher morbidity, mortality, and staff burnout. Emergency Physicians+1
https://www.emergencyphysicians.org/siteassets/emphysicians/all-images/advocacy/lac25_boarding.pdf
https://www.acep.org/administration/crowding--boarding
New research links ED crowding and boarding to errors and mortality
Recent peer-reviewed work finds ED crowding and boarding directly and indirectly tied to patient mortality and safety events, reinforcing the need for system-level capacity solutions. PMC+1
https://pmc.ncbi.nlm.nih.gov/articles/PMC12145972/
https://www.sciencedirect.com/science/article/abs/pii/S0167629618311676
Recommendations
Implement split-flow models and Rapid Medical Evaluation (RME)
National emergency medicine literature supports split-flow and rapid-evaluation models to decompress triage, expedite low-acuity care, and reduce length of stay and LWBS rates. ACEP+1
https://www.acep.org/administration/crowding--boarding
https://www.beckershospitalreview.com/care-coordination/hospital-capacity-in-2025-5-notes-on-volumes-boarding-and-length-of-stay/
Scale ED telepsychiatry to accelerate disposition for behavioral health patients
Studies show that EDs using telepsychiatry shorten time to psychiatric evaluation, reduce LOS, and improve cost-effectiveness and staff satisfaction. PMC+2PMC+2
https://pmc.ncbi.nlm.nih.gov/articles/PMC8857309/
https://pmc.ncbi.nlm.nih.gov/articles/PMC10024260/
https://bnrc.springeropen.com/articles/10.1186/s42269-024-01164-8
Case Study
Case Study: ED telepsychiatry reduces congestion and improves experience
Multi-site evaluations of ED telepsychiatry programs demonstrate shorter LOS, reduced transfer rates, and improved patient and clinician satisfaction when psychiatric expertise is available virtually. PMC+1
https://www.jmir.org/2024/1/e51814/
https://pmc.ncbi.nlm.nih.gov/articles/PMC10024260/
TOPIC 4 — Bed Placement Throughput
News
Discharge delays linked to post-acute and SNF capacity bottlenecks
Recent national commentary highlights that modest LOS improvements are fragile because hospitals cannot move medically ready patients out due to shortages in nursing homes, rehab, and behavioral health. Becker's Hospital Review+1
https://www.beckershospitalreview.com/care-coordination/hospital-capacity-in-2025-5-notes-on-volumes-boarding-and-length-of-stay/
https://www.aha.org/system/files/media/file/2024/11/2025-Health-Care-Workforce-Scan.pdf
Medicare Advantage discharge patterns complicate SNF admissions
Emerging analyses show that Medicare Advantage utilization review and discharge patterns can slow hospital discharge and reshape SNF admissions, further stressing bed capacity. PMC+1
https://pmc.ncbi.nlm.nih.gov/articles/PMC12418216/
https://skillednursingnews.com/2025/11/slower-hospital-discharge-of-medicare-advantage-patients-shapes-snf-admissions-practices/
Recommendations
Form and actively manage preferred SNF networks
Evidence from Health Affairs and follow-on implementation guides shows that preferred SNF networks can reduce 30-day readmission rates and improve care coordination under value-based arrangements. PMC+2Relias+2
https://www.healthaffairs.org/doi/abs/10.1377/hlthaff.2017.0211
https://www.relias.com/blog/partnering-with-hospitals-can-boost-snf-referrals
https://essentialhospitals.org/the-crucial-role-of-skilled-nursing-facilities-in-reducing-hospital-readmissions/
Use predictive placement and LOS tools in bed management huddles
Recent work emphasizes combining discharge probability models with daily operational huddles to identify patients nearing readiness and to initiate post-acute referrals days in advance. JAMA Network+3Mayo Clinic+3Mayo Clinic Proceedings+3
https://www.mayo.edu/research/clinical-trials/cls-20114271
https://www.mayoclinicproceedings.org/article/S0025-6196%2820%2931482-8/fulltext
https://substack.com/home/post/p-159760821
https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2830389
Case Study
Case Study: Nursing home staffing and SNF networks in readmission and LOS reduction
Analyses of preferred SNF networks and SNF staffing show that better-staffed, higher-rated SNFs in preferred networks achieve lower readmissions and shorter stays, supporting hospital capacity and value-based performance. PMC+1
https://www.healthaffairs.org/doi/abs/10.1377/hlthaff.2017.0211
https://essentialhospitals.org/the-crucial-role-of-skilled-nursing-facilities-in-reducing-hospital-readmissions/
TOPIC 5 — Patient Satisfaction & Engagement
News
National HCAHPS trends: communication remains central to experience
CMS and HCAHPS summary reports continue to show that communication with nurses and doctors strongly shapes overall ratings and “would recommend” scores. hcahpsonline.org+1
https://hcahpsonline.org/en/summary-analyses/
https://www.cms.gov/medicare/quality/initiatives/hospital-quality-initiative/hcahps-patients-perspectives-care-survey
Better nurse work environments drive better HCAHPS and safety outcomes
Press Ganey’s analysis of 2024 data links strong nurse practice environments to higher HCAHPS scores and better safety, reinforcing the value of investment in frontline teams. Press Ganey
https://info.pressganey.com/press-ganey-blog-healthcare-experience-insights/better-nurse-work-environments-better-outcomes
Recommendations
Standardize bedside whiteboards and visual tools for communication
Quality-improvement and research studies show that standardized bedside whiteboards and visual tools increase patients’ awareness of care plans and discharge timing, and improve satisfaction and communication scores. OUP Academic+1
https://academic.oup.com/ijcoms/article/3/1/lyad007/7190133
https://pubmed.ncbi.nlm.nih.gov/29091982/
Combine team-based rounding with real-time service recovery
Data from rounding initiatives and HCAHPS-focused toolkits show that interactive, two-way rounding improves experience scores, staff engagement, and safety culture. patientsafetyj.com+2Cipherhealth+2
https://patientsafetyj.com/article/126070-tackling-throughput-with-a-novel-care-team-rounding-model
https://cipherhealth.com/blog/how-to-improve-patient-satisfaction-through-rounding/
https://www.huronconsultinggroup.com/insights/improving-hcahps
Case Study
Case Study: Synchronous post-discharge texting improves experience and revisits
Houston Methodist and other systems report that synchronous post-discharge texting programs can improve patient experience and reduce revisits/readmissions by catching issues early and enabling rapid follow-up. PMC+3Artera+3JAMA Network+3
https://artera.io/blog/post-discharge-texting-insights-houston-methodist/
https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2797716
https://pmc.ncbi.nlm.nih.gov/articles/PMC11613675/
https://pmc.ncbi.nlm.nih.gov/articles/PMC11366300/
TOPIC 6 — Patient Safety & Culture
News
BCMA and medication safety: human factors still matter
Recent studies of barcode medication administration (BCMA) show that consistent use reduces harm from medication errors, but workarounds and usability issues can undermine its impact. PMC+3PMC+3LWW Journals+3
https://pmc.ncbi.nlm.nih.gov/articles/PMC11784319/
https://journals.lww.com/journalpatientsafety/fulltext/2025/12000/facilitators_and_barriers_associated_with_the_use.1.aspx
https://www.sciencedirect.com/science/article/pii/S2542454818301012
https://pmc.ncbi.nlm.nih.gov/articles/PMC8606443/
Responding to safety events requires structured, transparent processes
Updated PSNet guidance emphasizes standardized reporting, investigation, and communication workflows as central to a strong safety culture. PSNet
https://psnet.ahrq.gov/primer/responding-patient-safety-events
Recommendations
Institutionalize daily safety huddles with tiered escalation
AHRQ and multiple implementation studies show that daily (including virtual) huddles improve situational awareness, teamwork, and early identification of safety threats. OJIN+3PSNet+3AHRQ+3
https://psnet.ahrq.gov/primer/improving-patient-safety-and-team-communication-through-daily-huddles
https://www.ahrq.gov/hai/tools/ambulatory-surgery/sections/sustainability/management/huddles-comp-kit.html
https://pmc.ncbi.nlm.nih.gov/articles/PMC8390736/
https://ojin.nursingworld.org/table-of-contents/volume-30-2025/number-1-january-2025/articles-on-previously-published-topics/virtual-huddles-improving-healthcare-team-participation-and-patient-experience/
Combine fall-prevention bundles with monitored alarms/video observation
AHRQ toolkits and recent ECRI reviews indicate that integrated fall bundles—including alarms and video monitoring—can lower fall incidence and related harm when properly staffed and monitored. AHRQ+2ECRI and ISMP+2
https://www.ahrq.gov/sites/default/files/publications/files/fallpxtoolkit_0.pdf
https://home.ecri.org/blogs/ecri-blog/five-key-takeaways-on-video-based-patient-monitoring-for-preventing-falls
https://scholarlyworks.ohiohealth.com/cgi/viewcontent.cgi?article=1003&context=nurse-residency-posters
Case Study
Case Study: Technology-enabled fall prevention and virtual monitoring
Health systems implementing person-operated video monitoring and smart bed/bed-exit alarms report lower fall rates, reduced fall-related injuries, and lower operational costs. Artisight+3ECRI and ISMP+3Stryker+3
https://home.ecri.org/blogs/ecri-blog/five-key-takeaways-on-video-based-patient-monitoring-for-preventing-falls
https://www.stryker.com/us/en/acute-care/products/fall-prevention-solutions.html
https://patientsafety.pa.gov/ADVISORIES/Pages/200409_14.aspx
https://www.artisight.com/solutions/patient-room/
QUALITY METRICS TO SHARE WITH YOUR TEAM (7 MAX)
37% of hospitals are still losing money despite overall margin improvement
https://www.beckershospitalreview.com/finance/37-of-hospitals-still-losing-money/ Becker's Hospital ReviewKaufman Hall data show operating margins improving, but rising costs remain a headwind
https://www.fiercehealthcare.com/hospitals/2025-outlook-hospital-finance-show-signs-stability-rising-costs-will-be-headwind Fierce HealthcareDenials now account for 3–5% of net patient revenue, with denial rates up to 10–15%
https://www.uasisolutions.com/tackling-the-surge-in-healthcare-denials uasisolutions.comEmergency department boarding is formally described as a national public health crisis
https://www.emergencyphysicians.org/siteassets/emphysicians/all-images/advocacy/lac25_boarding.pdf Emergency PhysiciansPreferred SNF networks have reduced 30-day readmissions by roughly 4–5 percentage points
https://www.healthaffairs.org/doi/abs/10.1377/hlthaff.2017.0211 PMCFrom July 2023–June 2024, the national HCAHPS response rate was ~23%, with communication domains strongly linked to overall ratings
https://www.flexmonitoring.org/sites/flexmonitoring.umn.edu/files/media/HCAHPS_Toolkit_0.pdf Flex Monitoring Team+1Automated 30-day post-discharge texting programs can cut 30-day acute care use by ~41%
https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2797716 JAMA Network
LEADERSHIP CALL TO ACTION (≤5)
Re-baseline your financial risk dashboard around denial trends and MA audit exposure
Use current denial index data and MA audit findings to map local risk and prioritize AI-enabled denial prevention and revenue integrity. uasisolutions.com+2Office of Inspector General+2
https://www.uasisolutions.com/tackling-the-surge-in-healthcare-denials
https://oig.hhs.gov/reports/all/2024/medicare-advantage-compliance-audit-of-specific-diagnosis-codes-that-humana-health-plan-inc-contract-h2649-submitted-to-cms/Stand up (or tighten) a daily capacity huddle that integrates ED, inpatient, and post-acute partners
Make LOS forecasts, discharge prediction tools, and SNF network data part of a single, tiered daily huddle focused on boarding and avoidable days. Emergency Physicians+3Becker's Hospital Review+3PSNet+3
https://www.beckershospitalreview.com/care-coordination/hospital-capacity-in-2025-5-notes-on-volumes-boarding-and-length-of-stay/
https://psnet.ahrq.gov/primer/improving-patient-safety-and-team-communication-through-daily-huddlesDesign a combined ED split-flow plus telepsychiatry model for your highest-volume site
Pilot a split-flow/RME model in tandem with telepsychiatry to decompress triage, reduce LOS for behavioral health patients, and cut LWBS rates. PMC+2PMC+2
https://pmc.ncbi.nlm.nih.gov/articles/PMC12145972/
https://pmc.ncbi.nlm.nih.gov/articles/PMC10024260/Formalize a preferred SNF network and embed it into discharge planning workflows
Codify preferred partners, quality thresholds, and communication standards, and ensure case management tools surface these options early in the stay. PMC+2America's Essential Hospitals+2
https://www.healthaffairs.org/doi/abs/10.1377/hlthaff.2017.0211
https://essentialhospitals.org/the-crucial-role-of-skilled-nursing-facilities-in-reducing-hospital-readmissions/Launch an integrated “Experience & Safety” bundle: bedside whiteboards, interactive rounding, and post-discharge texting
Combine standardized bedside visual tools, interactive team rounding, and automated texting to improve communication, experience scores, and 30-day outcomes. Artera+3OUP Academic+3patientsafetyj.com+3
https://academic.oup.com/ijcoms/article/3/1/lyad007/7190133
https://patientsafetyj.com/article/126070-tackling-throughput-with-a-novel-care-team-rounding-model
https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2797716
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